Design for medical simulation: guidelines and visioning for a new model of education

In complex design contexts, which require horizontal management of vertical knowledge, design is taking on roles increasingly distant from those that originally distinguished it. Strategic visions and methodologies conceive the figure of the designer as a mediator between actors and knowledge with highly different background and great intercommunication and design difficulties; and as a catalyst for the processes around innovation. This paper was born from first research, contextualized to the present, which focused on the development of guidelines for the creation of tools and environments, in order to improve the simulation techniques used to provide training to medical professionals and students, that act in contexts of urgency and emergency. Having defined the design direction to follow in the aforementioned research, it is necessary to go for a visioning operation projecting the medical simulation in the near future (2030), where the scientific and technological progress allows to hypothesize a remarkable innovation in the system already proposed. This process is fundamental in order to anticipate and propose innovative ways to use innovative technologies. This research is developed by an open-source and cooperative network composed of SIMNOVA, a medical simulation center based in Novara, LogosNet, a company that works in the field of virtual reality and the Design Department of the Politecnico di Milano with its project and management skills, with the aim of creating tools and guidelines for a new model of medical education

NiCuMo-SiO2 catalyst for pyrolysis oil upgrading: model acidic treatment study

The main reasons of catalysts deactivation in hydro-processing pyrolysis liquids are by coke deposition, poisoning by bio-oil impurities (S, N, K, Cl, etc.), leaching of catalyst components, structural degradation in the presence of H2O, and sintering. The deactivation of catalysts by the acidity of the pyrolysis liquid is a specific concern, and this deactivation mechanism was studied by treating newly developed NiCuMo-SiO2 catalysts in 1 M acetic acid water solution (pH = 2-3). The activity of the acid-treated catalysts was subsequently investigated in the hydrodeoxygenation of gaseous propionic acid, in a tubular reactor at 225 degrees C with n-hexane and n-octane serving as diluent and internal standard, respectively. The samples treated by acid at different times (15-360 min) were characterized by X-ray diffraction (XRD), high resolution transition electron microscopy (HRTEM), X-ray fluorescence (XRF), CO chemisorption, N-2 physical adsorption, and X-ray photoelectron spectroscopy (XPS). XRF and HRTEM studies together with the residual mass of catalyst pointed out at gradual leaching of catalyst components. Among the catalyst components, dissolution of nickel was the most pronounced, while molybdenum content decreased to a lesser extent. This is due to the formation of more acid stable molybdenum blues. The amount of copper decreased only slightly, due its higher electrochemical potential. Oxidation of metallic species Cu and Ni is shown to obtain Cu2O, NiO and Ni(OH)(2)-like phases. Interestingly, the acidic treatment resulted in increasing active surface of the catalyst, nevertheless, the catalyst activity in propionic acid conversion irreversibly decreased in time by the acetic acid treatment due to loss of the active components (substantially nickel)

Denosumab densitometric changes assessed by quantitative computed tomography at the spine and hip in postmenopausal women with osteoporosis

FREEDOM was a phase 3 trial in 7808 women aged 60-90 yr with postmenopausal osteoporosis. Subjects received placebo or 60 mg denosumab subcutaneously every 6 mo for 3 yr in addition to daily calcium and vitamin D. Denosumab significantly decreased bone turnover; increased dual-energy X-ray absorptiometry (DXA) areal bone mineral density (aBMD); and significantly reduced new vertebral, nonvertebral, and hip fractures. In a subset of women (N = 209), lumbar spine, total hip, and femoral neck volumetric BMD (vBMD) were assessed by quantitative computed tomography at baseline and months 12, 24, and 36. Significant improvement from placebo and baseline was observed in aBMD and vBMD in the denosumab-treated subjects at all sites and time points measured. The vBMD difference from placebo reached 21.8%, 7.8%, and 5.9%, respectively, for the lumbar spine, total hip, and femoral neck at 36 mo (all p < 0.0001). Compared with placebo and baseline, significant increases were also observed in bone mineral content (BMC) at the total hip (p < 0.0001) largely related to significant BMC improvement in the cortical compartment (p < 0.0001). These results supplement the data from DXA on the positive effect of denosumab on BMD in both the cortical and trabecular compartments